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Travelers Diarrhea

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1. Rifamycin (Aemcolo) - To treat travelers? diarrhea

Rifamycin (Aemcolo) - To treat travelers? diarrhea Drug Approval Package: AEMCOLO (rifamycin) U.S. Department of Health and Human Services Search FDA Submit search Drug Approval Package: AEMCOLO (rifamycin) Company:Cosmo Technologies, Inc. Application Number: 210910Orig 1 Approval Date: 11/16/2018 Persons with disabilities having problems accessing the PDF files below may call (301) 796-3634 for assistance. FDA Approval Letter and Labeling (PDF) (PDF) FDA Application Review Files (PDF) (PDF

2019 FDA - Drug Approval Package

3. Traveller's diarrhoea

Traveller's diarrhoea Traveller's diarrhoea - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Traveller's diarrhoea Last reviewed: February 2019 Last updated: November 2017 Summary Occurs in 20% to 50% of people travelling to a less developed country, due to contaminated food or water, usually within the first 2 weeks of exposure. Prevention strategies include careful selection of food and beverages. Treatment (...) at the onset of diarrhoea with either quinolone antibiotics, azithromycin, or rifaximin, in addition to the use of loperamide, will quickly alleviate symptoms of bacterial traveller's diarrhoea. Quinolone resistance is a growing problem, particularly in Campylobacter infections acquired in south and SE Asia, where azithromycin is a better treatment choice than ciprofloxacin. Definition Traveller's diarrhoea (TD) is defined as ≥3 unformed stools in 24 hours accompanied by at least 1 of the following: fever

2017 BMJ Best Practice

4. Summary of the Committee to Advise on Tropical Medicine and Travel (CATMAT) statement on travellers' diarrhea

and harms based on available evidence on antimicrobial resistance patterns. "Best practice" recommendations for prevention of travellers' diarrhea CATMAT suggests Handwashing with soap and water before preparing meals, before eating meals, and after urination or defecation. Alcohol-based hand sanitizers may aid in reducing the risk of diarrheal illness among travellers. Consumption of undercooked or raw meats and seafood , and unpasteurized eggs and dairy products are best avoided. Foods cooked earlier (...) of a global survey. J Travel Med. 2004 Jul-Aug;11(4):231-7. Footnote 6 Steffen R, Collard F, Tornieporth N, Campbell-Forrester S, Ashley D, Thompson S, et al. Epidemiology, etiology, and impact of traveler's diarrhea in Jamaica. JAMA. 1999 Mar 3;281(9):811-7. Footnote 7 DuPont HL. Systematic review: The epidemiology and clinical features of travellers' diarrhoea. Aliment Pharmacol Ther. 2009 Aug;30(3):187-96. Footnote 8 Committee to Advise on Tropical Medicine and Travel (CATMAT). Statement on Travellers

2015 CPG Infobase

5. Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia. Full Text available with Trip Pro

Previous exposure in a high-risk area for travellers' diarrhoea within the past year is associated with a significant protective effect for travellers' diarrhoea: a prospective observational cohort study in travellers to South Asia. Travellers' diarrhoea is the most common health problem in travellers. Depending on the region visited, up to 40% of travellers develop diarrhoea during a 2-week trip. The aim of this study was to assess risk factors for TD among travellers to the Indian (...) subcontinent.An observational prospective multicentre cohort study investigated travellers to the Indian subcontinent. Participants completed questionnaires assessing the incidence of travellers' diarrhoea and identifying potential risk factors. Covariates were assessed univariately, followed by a multivariate regression.Two-hundred and twenty-six travellers were enrolled into the study, 178 filled in both pre- and post-travel questionnaires. Overall, the attack rate of travellers' diarrhoea was 38.2%. Travel

2017 Journal of Travel Medicine

6. Despite Predominance of Uropathogenic/Extraintestinal Pathotypes Among Travel-acquired Extended-spectrum β-Lactamase-producing Escherichia coli, the Most Commonly Associated Clinical Manifestation Is Travelers' Diarrhea. Full Text available with Trip Pro

Despite Predominance of Uropathogenic/Extraintestinal Pathotypes Among Travel-acquired Extended-spectrum β-Lactamase-producing Escherichia coli, the Most Commonly Associated Clinical Manifestation Is Travelers' Diarrhea. One-third of the 100 million travelers to the tropics annually acquire extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE), with undefined clinical consequences.Symptoms suggesting Enterobacteriaceae infections were recorded prospectively among 430 (...) ESBL-PE carriers, manifestations of Enterobacteriaceae infection included travelers' diarrhea (TD) (75/90 subjects) and urinary tract infection (UTI) (3/90). The carriers had 96 ESBL-producing E. coli isolates, 51% exhibiting a molecular pathotype: 13 (14%) were DEC (10 EAEC, 2 EPEC, 1 ETEC) (12 associated with TD) and 39 (41%) ExPEC/UPEC (none associated with UTI). Of ESBL-PE, 3 (3%) were ExPEC/UPEC-EAEC hybrids (2 associated with diarrhea, none with UTI). Potential ESBL-PE infections were

2019 Clinical Infectious Diseases

7. Diarrhoea - prevention and advice for travellers

% of episodes last for longer than 1 week, 5% persist for longer than 2 weeks, and 1% have a duration of more than 30 days [ ]. Prolonged diarrhoeal symptoms are more likely if the person is immunocompromised or has a protozoal infection. Protozoal diarrhoea can persist for weeks to months without treatment [ ]. Management Management : covers the prevention of travellers' diarrhoea, and advice for people who are at risk of travellers' diarrhoea. Scenario: Diarrhoea - prevention and advice for travellers (...) a diarrhoeal illness might severely impact on their health. Have a history of significant long-term morbidity after an enteric infection (for example reactive arthritis). Are undertaking critical trips in which a short bout of diarrhoea could severely impact the purpose of the trip (for example athlete, politician, professional musician, lecturer). May not have access to adequate medical treatment if they experience complicated travellers' diarrhoea. Basis for recommendation Basis for recommendation

2019 NICE Clinical Knowledge Summaries

8. Estimating the incidence of norovirus acute gastroenteritis among US and European international travelers to areas of moderate to high risk of traveler's diarrhea: a prospective cohort study protocol. Full Text available with Trip Pro

Estimating the incidence of norovirus acute gastroenteritis among US and European international travelers to areas of moderate to high risk of traveler's diarrhea: a prospective cohort study protocol. Acute gastroenteritis (AGE) is the leading cause of illness among returning travelers seeking medical care. Multiple types of enteric pathogens can cause travel-acquired AGE and, while bacterial pathogens have a predominant role, the importance of viruses, such as norovirus, is increasingly (...) recognized. There is a lack of information on travel-acquired norovirus incidence among symptomatic and asymptomatic individuals irrespective of healthcare-seeking behavior. Our aim is to estimate the incidence of travel-acquired AGE due to norovirus and to characterize the burden of disease among international travelers from the United States and Europe.We describe a prospective cohort study implemented in five US and European sites to estimate the role of AGE due to norovirus among adult international

2018 BMC Infectious Diseases

9. Review: chronic and persistent diarrhea with a focus in the returning traveler Full Text available with Trip Pro

Review: chronic and persistent diarrhea with a focus in the returning traveler Travelers' diarrhea is a common malady afflicting up to 50% of travelers after a 2-week travel period. An appreciable percentage of these cases will become persistent or chronic. We summarized the published literature reporting persistent/chronic diarrhea in travelers elucidating current understanding of disease incidence, etiology and regional variability.We searched electronic databases (Medline, Embase (...) heterogeneity statistics, graphically represented with Forest plots.We identified 19 studies meeting the inclusion criteria (all published after 1999). 18 studies reported upon the incidence of persistent/chronic diarrhea as a syndromic diagnosis in returning travelers; one study reported adequate denominator data from which to assess pathogen specific etiology. Giardiasis comprise an appreicaible percentage of infectious mediated persistent/chronic diarrhea in returning travelers. The overall estimate

2017 Tropical diseases, travel medicine and vaccines

10. Emerging concepts in the diagnosis, treatment, and prevention of travelers' diarrhea. (Abstract)

Emerging concepts in the diagnosis, treatment, and prevention of travelers' diarrhea. Traveller's diarrhea, though not life-threatening. is often a vexing problem, which impacts overall function of the traveller while on holiday. Increasing data is available regarding molecular diagnostic techniques, which may help obtain an early etiologic diagnosis. Use of antibiotics for traveller's diarrhea is controversial in this era of multidrug resistance and microbiome disruption.Travel to the tropics (...) promotes gut colonization with drug-resistant bacteria and this risk increases after treatment with antibiotics, leading to potential ecological impacts in the country of residence.Traveller's diarrhea is common and can impact a traveller's itinerary leading to significant inconvenience, and occasional longer term sequelae. Though bacterial causes predominate, recommended treatment is conservative in mild-to-moderate cases. Molecular techniques for early diagnosis of traveller's diarrhea may help

2019 Current Opinion in Infectious Diseases

11. AGA Clinical Practice Guidelines on the Laboratory Evaluation of Functional Diarrhea and Diarrhea-Predominant Irritable Bowel Syndrome in Adults (IBS-D) Full Text available with Trip Pro

of at least 4 weeks duration. This would exclude those patients with bloody diarrhea; diarrhea with signs of fat malabsorption; presentations with alarm features, such as weight loss, anemia, and hypoalbuminemia; those patients with a family history of inflammatory bowel disease (IBD), colon cancer, or celiac disease; and those with a travel history to regions with recognized specific diarrhea-related pathogens. This guideline was developed using a process outlined elsewhere. x 1 American (...) either detection of Giardia antigens or polymerase chain reaction for the Giardia small subunit ribosomal RNA. Because treatments are straightforward, there is little risk in utilizing these tests in evaluation of chronic watery diarrhea. Recommendation 4: In patients presenting with chronic diarrhea with no travel history to or recent immigration from high-risk areas, the AGA suggests against testing for ova and parasites (other than Giardia ). Conditional recommendation: low-quality evidence

2019 American Gastroenterological Association Institute

12. Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers. Full Text available with Trip Pro

Travelers' Diarrhea and Other Gastrointestinal Symptoms Among Boston-Area International Travelers. AbstractThis prospective cohort study describes travelers' diarrhea (TD) and non-TD gastrointestinal (GI) symptoms among international travelers from the Boston area, the association of TD with traveler characteristics and dietary practices, use of prescribed antidiarrheal medications, and the impact of TD and non-TD GI symptoms on planned activities during and after travel. We included adults who (...) received a pre-travel consultation at three Boston-area travel clinics and who completed a three-part survey: pre-travel, during travel, and post-travel (2-4 weeks after return). TD was defined as self-reported diarrhea with or without nausea/vomiting, abdominal pain, or fever. Demographic and travel characteristics were evaluated by χ2 test for categorical and Wilcoxon rank-sum test for continuous variables. Analysis of dietary practices used logistic generalized estimating equation models or logistic

2017 American Journal of Tropical Medicine & Hygiene

13. Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru. Full Text available with Trip Pro

Case-Case Analysis Using 7 Years of Travelers' Diarrhea Surveillance Data: Preventive and Travel Medicine Applications in Cusco, Peru. AbstractIn Cusco, Peru, and South America in general, there is a dearth of travelers' diarrhea (TD) data concerning the clinical features associated with enteropathogen-specific infections and destination-specific risk behaviors. Understanding these factors would allow travel medicine providers to tailor interventions to patients' risk profiles and travel (...) destination. To characterize TD etiology, evaluate region-specific TD risk factors, and examine relationships between preventive recommendations and risk-taking behaviors among medium- to long-term travelers' from high-income countries, we conducted this case-case analysis using 7 years of prospective surveillance data from adult travelers' presenting with TD to a physician in Cusco. At the time of enrollment, participants provided a stool sample and answered survey questions about demographics, risk

2017 American Journal of Tropical Medicine & Hygiene

14. Effectiveness of rifaximin and fluoroquinolones in preventing travelers' diarrhea (TD): a systematic review and meta-analysis

Effectiveness of rifaximin and fluoroquinolones in preventing travelers' diarrhea (TD): a systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.

2012 DARE.

15. Emergence of resistance to quinolones and β-lactam antibiotics in enteroaggregative and enterotoxigenic <i>Escherichia coli</i> causing traveler's diarrhea. Full Text available with Trip Pro

Emergence of resistance to quinolones and β-lactam antibiotics in enteroaggregative and enterotoxigenic Escherichia coli causing traveler's diarrhea. The objective of this study was to assess the antimicrobial resistance of enteroaggregative Escherichia coli (EAEC) and enterotoxigenic E. coli (ETEC) strains causing traveler's diarrhea (TD) and to investigate the molecular characterization of antimicrobial resistance genes to third-generation cephalosporins, cephamycins, and quinolones (...) to quinolones of EAEC and ETEC strains causing TD has significantly increased over the last decades, and high percentages have been found especially in patients traveling to India and sub-Saharan Africa. Sequence type 38 (ST38) and ST131, carrying the blaCTX-M-15 and blaCTX-M-27 genes, respectively, are highly prevalent among extended-spectrum β-lactamase (ESBL)-producing EAEC and ETEC strains. The cephamycinase ACT-20 is described in the present study for the first time in EAEC and ETEC strains causing TD

2018 Antimicrobial Agents and Chemotherapy

16. Travelers' diarrhea in Thailand: a quantitative analysis using TaqMan® Array Card. Full Text available with Trip Pro

Travelers' diarrhea in Thailand: a quantitative analysis using TaqMan® Array Card. Travelers' diarrhea (TD) is a common illness experienced by travelers from developed countries who visit developing countries. Recent questionnaire-based surveillance studies showed that approximately 6%-16% of travelers experienced TD while visiting Thailand; however, a majority of TD information was limited mainly to US military populations.A TD surveillance study was conducted at Bumrungrad International (...) by the diarrheagenic Escherichia coli and norovirus GII. These agents had significant pathogen-disease associations as well as high attributable fractions among diarrheal cases. A wide range of pathogen loads for Campylobacter spp. was associated with TD, while heat-labile toxin enterotoxigenic Escherichia coli was associated with an increased pathogen load. Most cases were associated with inflammatory diarrhea, while Campylobacter spp. and Shigella spp. were associated with dysentery.A pan-molecular diagnostic

2018 Clinical Infectious Diseases

17. Multiplex PCR reveals a high prevalence of multiple pathogens in traveller's diarrhoea in children. (Abstract)

Multiplex PCR reveals a high prevalence of multiple pathogens in traveller's diarrhoea in children. Traveller's diarrhoea (TD) is one of the most frequent illnesses affecting children returning from tropical countries. The purpose of this study was to assess the distribution of pathogens associated with TD in children using a multiplex PCR assay on stool samples.All the children admitted for TD in two university hospitals from 1 August to 15October during 2014 and 2015 were included

2018 Archives of Disease in Childhood

18. Non-pharmacotherapeutic interventions in travellers diarrhoea (TD). Full Text available with Trip Pro

Non-pharmacotherapeutic interventions in travellers diarrhoea (TD). This is a review of some of the non-pharmacotherapeutic interventions in travellers diarrhoea (TD) looking particularly at the role of pre and probiotics, the evidence behind water purification and the impact of advice given and its adherence by travellers.A systematic review of the research completed under section using the listed key words and searched using the databases of Google Scholar, Journal of Travel Medicine, QxMD (...) , ReadCube and The Knowledge Network.Travellers' diarrhoea and use of pre/probiotics: There is no significant evidence to suggest the benefit of using pre or probiotics to prevent or treat TD. A new second generation of B-GOS prebiotics shows some potential in preventing the incidence and symptoms of TD but lack high levels of graded evidence. Recent reports from the biotics industry suggest that a review of the above issues is being addressed and in the future more robust studies may be completed

2018 Journal of Travel Medicine

19. Antibiotic resistance in travellers' diarrhoeal disease, an external perspective. Full Text available with Trip Pro

Antibiotic resistance in travellers' diarrhoeal disease, an external perspective. There are many recommendations on the use of antibiotics for prophylaxis and treatment of travellers' diarrhoea (TD). As pharmacists with a special interest in antimicrobial stewardship, we examine and offer our perspective on advice that is recommended to travellers in terms of prevention, treatment and management of TD with a focus on antibiotic use and resistance.Publications on TD were identified through (...) PubMed, Google Scholar and Cochrane Library databases searches using search terms 'travellers diarrhoea', 'travellers diarrhoea', 'travellers' diarrhoea' 'guidelines', 'expert opinion', 'expert reviews', 'South Asia' and 'South East Asia' (S and SE Asia), 'antibiotics', 'resistance genes', 'travel advice', 'pharmacists', 'guidelines', 'prevention' and 'treatment'. References of articles were also screened for additional relevant studies.Whilst most guidelines and expert reviews were in agreement

2018 Journal of Travel Medicine

20. Use of a multiplex DNA extraction PCR in the identification of pathogens in travelers' diarrhea. Full Text available with Trip Pro

Use of a multiplex DNA extraction PCR in the identification of pathogens in travelers' diarrhea. Diarrhea is one of the most common ailments afflicting travelers with attack rates of 30-40% for medium to high-risk destinations. As travelers' diarrhea (TD) is syndromic and caused by a wide range of pathogens, including bacteria, parasites and viruses, multiplex deoxyribonucleic acid (DNA) extraction polymerase chain reaction (PCR) technology can be useful for determining the etiology of TD (...) by specific region.Stool analysis by DNA extraction PCR was obtained in 388 post-travel patients. Three hundred and twenty-seven of these had diarrhea or other enteric symptoms. Sixty-one travelers presented with enteric symptoms and were diagnosed with post infectious irritable bowel syndrome (PI-IBS) after stool analyses were negative. Of those with diarrhea or gastrointestinal (GI) symptoms and excluding those diagnosed with PI-IBS, 207 patients tested positive for at least 1 enteric pathogen (63.4

2018 Journal of Travel Medicine

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